Ag. Williams et al., The effect on hospital admission profiles of establishing an emergency department observation ward, MED J AUST, 173(8), 2000, pp. 411-414
Citations number
8
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Objective: To determine the effect of establishing an emergency department
observation ward (OW) on admission numbers, average length of stay (ALOS) f
or the entire hospital and overall bed days for conditions commonly treated
in the OW.
Setting: Sir Charles Gairdner Hospital (SCGH), Perth, a tertiary referral t
eaching hospital.
Design: Retrospective analysis of routinely collected hospital data for the
10 most common diagnosis-related group (DRG) categories of patients discha
rged from the OW for the financial years 1995-96 to 1998-99. Comparison of
these data with those for adult patients at the other Perth teaching hospit
als over the same period.
Main outcome measures: For patients in the 10 most common DRGs: numbers of
admissions to the OW compared with other inpatient wards; total number of p
atients admitted to the hospital compared with total bed days; ALOS at SCGH
compared with other Perth teaching hospitals.
Results: Increased admissions to the OW were paralleled by a decrease in ad
missions for the same DRG codes to other inpatient wards. ALOS remained app
roximately the same from 1995-96 to 1998-99 for patients in the OW (one day
) and other inpatient wards (4.38 to 4.20 days). However, overall ALOS for
patients in these DRGs fell by over a third (from 3.97 to 2.59 days) over t
his time. The total number of patients in these DRGs treated by the hospita
l increased by 19% over the four years, but the total number of bed days fe
ll by 23%. By contrast, the ALOS for patients in the same DRGs treated at t
he other Perth teaching hospitals rose 8% (from 2.12 to 2.28 days).
Conclusion: Establishment of a formal emergency department OW results in th
e more efficient management of certain groups of patients, with a decrease
in overall hospital bed days and length of stay.